髓外多发性骨髓瘤对 idecabtagene vicleucel 疗效的影响

Idecabtagene vicleucel (Ide-cel) has demonstrated excellent efficacy and durable responses in patients with relapsed/refractory multiple myeloma (RRMM).

However, the outcomes with ide-cel in patients with extramedullary disease (EMD) remain incompletely characterized.

We included patients with RRMM treated with ide-cel between May 2021 and April 2023 across 11 US academic institutions. Visceral or soft tissue lesions non-contiguous from bone was classified as EMD. Time-to-event analyses were performed from date of ide-cel infusion. Among 351 patients, 84 (24%) had EMD prior to infusion. The median follow-up from ide-cel infusion was 18. 2 months (95% CI: 17-19. 3). The day 90 overall response rates (ORR) were 52% vs. 82% for the EMD and non-EMD cohorts, respectively (p < 0. 001). The median progression-free survival (PFS) was 5.

3 months (95% CI: 4. 1-6. 9) for the EMD cohort vs. 11. 1 months (95% CI: 9. 2-12. 6; p < 0. 0001) for the non-EMD cohort. In a multivariable analysis, EMD was an independent predictor of inferior PFS [hazard ratio 1. 5 (1. 1-2. 2), p = 0. 02]. The median overall survival was 14. 8 months [95% CI: 9-Not reached (NR)] vs. 26. 9 months (26. 3 vs. NR, p = 0. 006) for the EMD and non-EMD cohorts, respectively. Extramedullary disease represents an independent predictor of inferior day 90 ORR and PFS among patients treated with ide-cel.